Article Text

Download PDFPDF

Extended report
The majority of newly diagnosed patients with juvenile idiopathic arthritis reach an inactive disease state within the first year of specialised care: data from a German inception cohort
  1. Claudia Sengler1,
  2. Jens Klotsche2,
  3. Martina Niewerth2,
  4. Ina Liedmann2,
  5. Dirk Föll3,
  6. Arnd Heiligenhaus4,
  7. Gerd Ganser5,
  8. Gerd Horneff6,
  9. Johannes-Peter Haas7 and
  10. Kirsten Minden2,7
  1. 1German Rheumatism Research Centre Berlin, a Leibniz Institute, Berlin, Germany
  2. 2Department of Paediatric Rheumatology and Immunology, University hospital Münster, Muenster, Germany
  3. 3Department of Ophthalmology at St. Franziskus Hospital Münster, University of Duisburg-Essen, Muenster, Germany
  4. 4St. Josef-Stift Sendenhorst, Sendenhorst, Germany
  5. 5Asklepios Children's Hospital, Sankt Augustin, Germany
  6. 6German Center for Paediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
  7. 7Charité Universitätsmedizin Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany
  1. Correspondence to Claudia Sengler; sengler{at}drfz.de

Abstract

Objective To describe the disease characteristics of patients with juvenile idiopathic arthritis (JIA) included in an inception cohort, to analyse how many patients from each JIA category reach an inactive disease state within the first year of specialised care and to determine predictors for attaining inactive disease.

Methods Patients with JIA were enrolled in this study at 11 large German paediatric rheumatology units within the first 12 months after diagnosis. Laboratory and clinical parameters such as JIA core criteria and data on the medication used were collected every 3 months. Non-parametric statistical testing was performed for the comparison of the JIA core criteria at follow-up. Generalised linear models were used to analyse differences in the rates at which inactive disease was reached and to determine potential predictors.

Results Of the 695 patients with JIA included in this analysis, approximately 75% experienced a period of inactive disease under treatment with disease-modifying antirheumatic drugs and systemic steroids in most cases with systemic-onset JIA or polyarthritis at least once during the first 12 months in ICON. Significant improvements were observed in all JIA core criteria, in disease activity and in functional status from baseline to the 12-month follow-up. Younger age at onset, a shorter duration between symptom onset and diagnosis and a positive antinuclear antibody status increased the probability of attaining an inactive disease state.

Conclusions The 12-month outcome of JIA was good under real-life conditions, with half of the patients having attained inactive disease with contemporary treatments. Since a short duration between symptom onset and diagnosis was correlated to a period of inactive disease, children suspected of having JIA should be transferred to specialised care as soon as possible.

  • Juvenile Idiopathic Arthritis
  • Outcomes research
  • Epidemiology

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.